Maryjane Mashunkashey, 63, was plagued with exhaustion — until she discovered the shocking culprit: a sneaky urinary tract infection, also known as a silent UTI. Unrecognized and untreated urinary tract infections (UTIs) can quickly turn into more serious conditions, and they're more likely to strike women than men. But what exactly is a silent UTI? Read on to find out more about this condition, along with the simple fix that can restore your vitality.
Silent UTIs: How They Start
“That weekend was supposed to be so fun. I always looked forward to hosting my grandchildren, who lived 45 miles away, overnight. But this time my extreme fatigue stole most of the energy and joy from our precious time together. The strange thing is, it wasn’t the ‘I probably did too much yesterday’ kind of tired. It was concerning," Mashunkashey said. "That heavy blanket of fatigue covered me the rest of the week. All I wanted to do was lie down, and that just wasn’t like me — I’m not a napping kind of person."
She visited her doctor to ask about the exhaustion, but her doctor couldn't provide an answer.
“This wasn’t like other health issues I’d had in the past, though. Years earlier I was prone to urinary tract infections. I once had six in the span of six months. I dreaded that unmistakable backache, the painful urination and the urgency to pee, not to mention the doctors’ appointments and prescription co-pays for all those antibiotics. Thankfully, I seemed to have outgrown UTIs, but this new health complaint was such a mystery... It worried me," Mashunkashey said.
How long can a UTI go untreated?
While on vacation, Mashunkashey's exhaustion got worse. By the second day, her sneaky symptoms had her frightened enough to visit the emergency room closest to her hotel.
“When the doctor told me it was a UTI, I was stunned. ‘I don’t believe it,’ I responded. ‘I don’t have any of the symptoms. None whatsoever!' Yet there was the proof on my chart, confirmed through a urine test. After my history of UTIs, I felt I was somewhat of an expert. I thought I knew how to recognize them. But this infection completely snuck up on me."
What is a UTI, and is it different from a silent UTI?
Urinary tract infections are pretty common among women, but can you guess where UTIs come from? A UTI is basically what it sounds like: an infection in any part of the urinary system, which includes the kidneys, ureters, bladder, and urethra. Most UTIs occur within the lower urinary tract, which is made up of the bladder and urethra. While the most common UTI symptoms in women include burning with urination, frequent urination, a sense of urgency to urinate, and pain in the area of the bladder, those symptoms don't always appear in older adults. The difference between a UTI and a silent UTI is that you often don't experience the typical symptoms of a UTI if you have the latter, hence why it's called "silent."
"It's not unusual to see a patient in her upper 70s or older who gets infections without symptoms," says George Flesh, MD, director of urogynecology and pelvic reconstructive surgery for Harvard Vanguard Medical Associates, according to Harvard Health Publishing. Some experts believe that's because the symptoms of a UTI are actually caused by the immune system's fight against the infection, and the immune systems of older people may not fight as fiercely.
What does a UTI feel like?
Generally, UTIs feel like a sharp burning sensation while urinating. "Oftentimes, the burning is from the acidic urine irritating the lining of the bladder and urethra," urologist Lisa Hawes, MD, told Reader's Digest. "The bacteria damages the lining of the bladder and urethra and then the acidic urine acts like alcohol over a cut, causing the burn." You may also experience itching and a constant feeling of needing to urinate. If you have a UTI, back pain might also be something you notice. Back pain is one of the common symptoms of a bladder infection, which is a type of UTI.
But can you have a UTI without pain? Could you be sick and not even know it? The scary answer is yes.
Silent UTI Symptoms
Silent UTI infections are tricky to detect because they may not come with typical urinary tract infection symptoms — namely, a burning sensation when peeing, a feeling of pain in the lower abdomen, and a near-constant urge to empty the bladder.
A major sign of a silent UTI? Extreme tiredness, like Mashunkashey experienced. If you have unexplained fatigue, a sneaky urinary tract infection could be to blame. A few more telltale signs of a UTI that may be present:
- Back pain
- Muscle aches
- Abdominal pressure or pain
Does a UTI make you tired?
“Though I’d never heard the term before, I found out there was such a thing as a ‘hidden’ or ‘silent’ UTI. Looking back, I realized that every time I’d suffered a UTI, I always felt fatigue first. It was my body’s way of trying to fight off infection," Mashunkashey said.
“After that ER visit, I took the antibiotics the doctor prescribed and headed home. I reclined my seat and relaxed the whole ride, knowing I finally had the information I needed to spot infections early so they wouldn’t damage my system and make me miss out on work and family fun.
“Sure enough, several months later I started feeling exhausted again. My gut reaction was to power through it, but then I remembered my vacation. Being proactive, I quickly asked my doctor to test my urine. As I suspected, it was another sneaky UTI," she said. "I felt empowered knowing I didn’t have to suffer for days or weeks before more serious symptoms may have shown up."
How to Prevent a Silent UTI
“I was so grateful my newfound knowledge was helping me improve my life. But I wasn’t satisfied with early detection. I wanted to find a way to prevent UTI infections," Mashunkashey added. "So, I kept pressing my doctor and I guess I finally asked the right question because I learned that taking vitamin C at bedtime can prevent bacteria from building up in the system. The doctor explained that [vitamin] C allows healthy acid to rest in the bladder overnight so that the harmful acid in urine can’t take hold. I started taking 1,000 mg each night and I haven’t had a single flare-up in years."
Vitamin C not only helps ward off UTIs, it can also outsmart stress. So say Canadian researchers in The American Journal of Clinical Nutrition. They gave 52 people who were deficient in vitamin C a daily dose of 500 mg and tracked their moods for eight days. The results? Study subjects experienced a 71 percent drop in symptoms including fatigue, sadness, and irritability, as well as a 51 percent decrease in anxiety. According to the study authors, vitamin C plays a crucial role in balancing the brain chemicals that rule our emotional response to stress.
How to Know If You Have a UTI
The scary truth: Up to 50 percent of women with energy-draining UTIs go undiagnosed, mainly because these women don't experience any of the "typical" symptoms they'd normally associate with other UTIs they've had before.
"At least 80 percent of women will get a urinary tract infection in their lifetime," says Laura Corio, MD, an OB-GYN in New York City. She adds that as many as 1 in 5 UTIs don’t cause the red flags most women associate with the infections, like burning or frequent urges to urinate. Instead, women notice fatigue, lower-back pain, and muscle aches — subtle symptoms they (and their doctors) don’t link to UTIs. As a result, says Pamela Peeke, MD, author of Body-for-LIFE for Women, up to half of "silent" UTIs go undiagnosed.
Women are most at risk for UTIs in the summer, since heat can cause bacterial growth in the urethra. The risk also goes up as estrogen levels plummet, since the hormone helps bolster the production of antimicrobial proteins in the bladder. Once an infection takes hold, the body revs its immune system, leading to inflammation that impairs the function of every system in the body. The result? Fatigue, body aches, weakness, and nausea.
Silent UTIs: How to Treat Them
If you're suffering from a silent UTI, there are a number of things you can do to diagnose it, treat it effectively, and prevent a future episode.
You can diagnose a UTI with an at-home urine test, like AZO UTI Test Strips, says Dr. Corio. If it's positive, see your doctor for confirmation, then try the products below to nix the infection and restore energy.
Where to buy: $9.02, Amazon
2. Treat, Relieve, and Prevent
The first line of treatment is prescription antibiotics, which kill infectious bacteria and relieve symptoms in days. But even when taking antibiotics, there are some additional measures you can follow to kick the UTI out of your system completely.
Probiotics for UTIs
Drinking kefir or fermented milk three times a week can cut your risk of getting another UTI by 79 percent, say scientists in The American Journal of Clinical Nutrition. Taking a probiotic supplement can have the same effect. These RAW acidophilus probiotics for women's vaginal care by Garden of Life take care of your vaginal and urinary tract health, and are gluten-, soy-, and GMO-free. They work by promoting yeast balance, and also help balance good bacteria and bad bacteria in various locations of the vagina, bladder, and stomach, ultimately relieving and preventing UTIs.
Where to buy: $30.79 for 30 capsules, Amazon
Vitamin C for UTIs
As previously mentioned, upping your intake of vitamin C can treat UTIs by acidifying the bladder, making it less hospitable to unhealthy bacteria. You can get a daily dose of vitamin C via grapefruit or unsweetened cranberry juice, but to make sure you're getting enough to tackle a UTI, try these Garden of Life vitamin C capsules.
Where to buy: $23.27 for 120 capsules, Amazon
Cotton Underwear for UTIs
Synthetic briefs are a big no-no if you are prone to UTIs. Paying extra care to the material of your panties can go a long way in preventing infections. This set of six Hanes women's 100 percent pure cotton brief panties prevent bacterial growth by allowing your vagina to "breathe," and won't aggravate any existing UTIs. They have an ultra-soft waistband for extra comfort and don't have those annoying scratchy labels either.
Where to buy: from $14.80, Amazon
Water for UTIs
Let's take it back to basics. Even before antibiotics or any other treatment, it goes without saying that you need to drink a lot of water as often as possible to treat and prevent UTIs. Water helps cleanse your system, and every time you pee, you empty your bladder and flush out the harmful bacteria from the urinary tract. Stay hydrated (and peeing) with this pack of 24 Glaceau Smartwaters, which are vapor-distilled with electrolytes for added taste. They also contain a unique blend of calcium, magnesium, and potassium for extra goodness.
Where to buy: $44.75 for a pack of 24, Amazon
Apple Cider Vinegar for UTIs
Apple cider vinegar is widely known and used for its amazing health benefits, and it's a natural remedy for UTIs, too. Its acidifying nature is great at clearing UTIs, and it helps prevent bacteria from spreading, stopping the infection before it reaches the kidneys. Try Bragg's organic raw apple cider vinegar. It's gluten-free and contains "Mother of Vinegar," a healthy bacteria that occurs naturally as strand-like enzymes of connected protein molecules. It's also loaded with vitamins and prebiotics, which relieve and prevent UTIs.
Where to buy: $8.78, Amazon
A version of this article first appeared in our print magazine.